去瓣与否对机械法准分子激光角膜上皮瓣下磨镶术治疗屈光不正的疗效

Curative effect observation of n-flap and off-flap EPi-LASIK in ametropia

目的:观察去瓣与否对机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situ keratomileusis,EPi-LASIK)治疗屈光不正的临床疗效。方法:临床纳入接受手术治疗的近视患者68例136眼,根据手术方案的不同分为研究组与对照组。研究组进行去瓣EPi-LASIK术,对照组进行非去瓣EPi-LASIK术。观察两组患者术前、术后1wk,1、4mo裸眼视力、屈光度、角膜上皮下雾状混浊(haze)程度等指标。结果:术后1mo裸眼视力:研究组为1.33±0.22,对照组为1.22±0.19,有统计学差异(P<0.05);柱镜度数:研究组为0.10±0.55D,对照组为0.30±0.82D,有统计学差异(P<0.05);术后1wk,haze:研究组明显低于对照组,有统计学差异(P<0.05)。结论:去瓣EPi-LASIK术与非去瓣EPi-LASIK术均是目前临床治疗屈光不正较为安全、有效的表层切削手术。角膜上皮瓣的存在对患者术后极早期的临床结果有着一定程度的影响,但是随着时间的推移,该影响呈现逐渐减小的趋势。

AIM：To observe the clinical effect of on-flap and offflap epipolis laser in situ keratomileusis（EPi-LASIK） in ametropia.METHODS：Sixty- eight myopia patients（136 eyes）receiving surgical treatment were selected and divided into research group and control group according to different therapies.The patients in research group adopted off-flap EPi-LASIK and those in control group adopted on-flap EPi-LASIK.The index like uncorrected visual acuity,diopter and Haze of two groups before surgery,1wk,1 and 4mo after surgery was observed.RESULTS：One month after surgery,the uncorrected visual acuity of research group was 1.33±0.22 while that of control group was 1.22±0.19（P〈0.05）;Cylindrical diopter of research group was 0.10±0.55 D while that of control group was 0.30±0.82D（P〈0.05）.One week after surgery,Haze of research group was 0.22±0.15 while that of control group was 0.23±0.18（P〈0.05）.？CONCLUSION：On-flap and off-flap EPi-LASIK are safe and effective surgery approaches in the clinical treatment of ametropia.The presence of corneal epithelial flap has a certain effect in the postoperative clinical outcome at early stage.The impact will be gradually reduced over time.